Thyroid Disorders and Surgery What is a thyroid disorder? Diseases of the thyroid gland are very common, affecting millions of Americans. The most common thyroid problems are: • An overactive gland, called hyperthyroidism (e.g., Graves disease, toxic adenoma or toxic nodular goiter) • An underactive gland, called hypothyroidism (e.g., Hashimotos thyroiditis) • Thyroid enlargement due to overactivity (as in Graves disease) or from under-activity (as in hypothyroidism). An enlarged thyroid gland is often called a goiter. Patients with a family history of thyroid cancer or who had radiation therapy to the head or neck as children for acne, adenoids, or other reasons are more prone to developing thyroid malignancy. What are thyroid nodules? Thyroid nodules are very common, occurring in 15-65 How is a diagnosis made? percent of people of all ages. They occur in both women and The diagnosis of a thyroid function abnormality or a men but are especially common in women (50 percent of thyroid mass is made by taking a medical history and a physical women ages 50 or older have had a thyroid nodule). examination. In addition, blood tests and imaging studies or Usually patients and their physicians first notice thyroid fine-needle aspiration may be required. As part of the exam, Dr. nodules during a routine physical exam of the neck area. Peters will examine your neck and ask you to lift up your chin to Sometimes they are found incidentally during a radiographic make your thyroid gland more prominent. You may be asked to evaluation of the neck (such as a CT scan, X-ray, MRI or swallow during the examination, which helps to feel the thyroid ultrasound). Although the vast majority of thyroid nodules and any mass in it. Tests your doctor may order include: are benign, the physician should evaluate a significant thyroid nodule, as approximately 5-10 percent of thyroid nodules • Evaluation of the larynx/vocal cords with a fiber optic are cancerous. In general, a thyroid nodule is considered telescope “significant” if it is one centimeter or larger and/or presents • An ultrasound examination of your neck and thyroid concerning features on ultrasound. • Blood tests of thyroid function • A nuclear thyroid scan What is thyroid surgery? • An ultrasound guided fine-needle aspiration biopsy There is no medical treatment for thyroid nodules. If a • A CT or MRI scan decision is made that the thyroid nodule needs to be removed,
surgical treatment is recommended. Nodules that are suspicious or cancerous on biopsy require surgical removal. Large nodules are often removed for a number of reasons. Benign large thyroid nodules may cause pressure symptoms in the throat or cause difficulty swallowing. Thyroid nodules that produce excess thyroid hormone may also need to be removed. Lastly, some thyroid nodules are large enough that standard diagnostic approaches prevent accurate assessment of the possibility of cancer and, therefore, need to be surgically removed. Thyroid surgery is an operation to remove part or all of the thyroid gland. It is performed in the hospital and general anesthesia is usually required. Typically, the operation removes the lobe of the thyroid gland containing the suspicious nodule or lump. A frozen section (immediate microscopic reading) may be used to determine if the rest of the thyroid gland should be removed during the same surgery. Based on the result of the frozen section, the decision will be made in the operating room if removal of any remaining thyroid tissue is necessary. Dr. Peters will discuss these options with you preoperatively. As an alternative, Dr. Peters may choose to remove only one lobe and wait for the final pathology report before deciding if the remaining lobe needs to be removed. If a malignancy is identified in this way, he may recommend that the remaining lobe of the thyroid be removed at a second procedure. What happens after thyroid surgery? The surgery usually takes 2-3 hours, and most patients are watched carefully in the hospital overnight. The pain is often minimal, and most patients take four to seven days off from work.
Dr. Bruce Peters is a board certified Otolaryngologist who established his practice in Ocean County in 1997. A graduate of Philadelphia College of Osteopathic Medicine and residency at Thomas Jefferson University Hospital, Philadelphia, Dr. Peters then completed his Fellowship in Facial Plastic Surgery and Reconstructive Surgery at the University of Miami Hospital. He specializes in functional and cosmetic nasal surgery, sinus surgery, thyroid surgery and skin cancer surgery. Dr. Peters is a member of the American College of Surgeons, the Academy of Otolaryngology, Head and Neck Surgery, the Academy of Facial Plastic Surgery and the N.J. Academy of Otolaryngology. He resides in Wall, N.J. with his wife and two daughters and enjoys golf and fishing in his leisure time.
Bruce W. Peters, DO, FACS
Stephen Kupferberg, MD, FACS
Christina Gillespie, MD
54 Bey Lea Rd., Suite 3, Toms River, NJ 61 Lacey Rd., Whiting, NJ 1673 Rt. 88 W, Brick, NJ
For more information, call 732-281-0100 or visit www.OceanENTFacialPlastics.com.
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Published on Jan 4, 2018
Published on Jan 4, 2018
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